Antecedentes médicos de los trabajadores de una institución universitaria pública en Popayán, Colombia

Introduction: Due to the demographic transition observed in Colombia, the prevalence of chronic non-communicable diseases has increased considerably, being one of the main causes of morbidity and mortality. Objective: To describe the personal and family medical history of the employees of a public university. Methods: Retrospective descriptive study, which included the employees of a university with assessment for occupational health registered in the database of the area of Occupational Safety and Health as of May 2018. Sociodemographic information, personal and family medical history were obtained, as well like your habits. Results: 1,152 employees participated in the study, 54.2% of the male gender, with an average age of 45.75 years. 88.8% had a family medical history, cardiovascular disease prevailing (68.9%); followed by cancer (51.0%). The most frequent personal pathological antecedents were: ophthalmological (82.2%), surgical (75.3%) and cardiovascular diseases (47.3%). Among the habits, 70% exercised regularly and less than 50% reported having a toxic habit. Conclusion: The comprehensive evaluation of workers is recommended to generate health and family burden profiles that may affect their work capacity and / or quality of life in the long term.Introducción: Debido a la transición demográfica observada en Colombia, la prevalencia de las enfermedades crónicas no transmisibles ha aumentado considerablemente, siendo una de las principales causas de morbimortalidad. Objetivo: Describir los antecedentes médicos personales y familiares de los empleados de una universidad pública. Métodos: Estudio descriptivo retrospectivo, que incluyó los empleados de una universidad con valoración por salud ocupacional registrados en la base de datos del área de Seguridad y Salud en el Trabajo a mayo de 2018. Se obtuvo información sociodemográfica, antecedentes médicos personales y familiares, así como sus hábitos. Resultados: Participaron en el estudio 1,152 empleados, 54.2% del género masculino, con un promedio de edad de 45.75 años. El 88.8% tuvo antecedentes médicos familiares, predominando la enfermedad cardiovascular (68.9%); seguida del cáncer (51.0%). Los antecedentes patológicos personales más frecuentes fueron: oftalmológicos (82.2%), quirúrgicos (75.3%) y enfermedades cardiovasculares (47.3%). Dentro de los hábitos, 70% hacía ejercicio de forma regular y menos del 50% manifestó tener algún hábito tóxico. Conclusión: Se recomienda la evaluación integral de los trabajadores para generar perfiles de salud y carga familiar que puedan afectar a largo plazo su capacidad laboral y/o calidad de vida

Indicaciones actuales del ecocardigrama transtorácico

Transthoracic echocardiogram (TTE) is a non invasive diagnosis method that uses ultrasound to evaluate the structure and function of the heart and its valves. This technique is appropriate when the information expected, combined with the clinical judgment, is adequate and is considered acceptable to define a patient's diagnosis and prognosis. The appropriate use of transthoracic echocardiogram by health professionals in their daily clinical practice allows the adequate implementation of this technology avoiding unnecessary expenses in the medical practice and in our health systems.El ecocardiograma transtorácico es un método diagnóstico no invasivo que utiliza el ultrasonido para evaluar la estructura, función del corazón y de sus válvulas. Esta técnica es apropiada cuando la información esperada, combinada con el juicio clínico es adecuada y se considerada aceptable para definir un diagnóstico y conducta en los pacientes con patología cardiovascular. La apropiada solicitud del ecocardiograma transtorácico en la práctica clínica cotidiana por parte del personal médico permite la implementación adecuada de esta tecnología evitando gastos innecesarios en la práctica médica y en nuestros sistemas de salud

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)